Coach Application – Empire Justice Center

Attendance at group meetings is required for program participation. Group meetings are generally held the second Wednesday of every month from 5:30-7:30pm at Consumer Credit Counseling Service of Rochester (1050 University Ave, Suite A. 14607).

View the Schedule for the upcoming cycle.

Have you volunteered as a Coach in the last three years?*

Please answer the following demographic questions: (if you are retired, please indicate under “employer”)

Name:*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email:*

Phone:*

Date of Birth*

Gender:*

If you prefer to specify, please share here:

Race (select all that apply):*

African-American
Hispanic/Latino
Caucasian
American Indian/Native American
Asian
Hawaiian or Pacific Islander
Other

Employer:*

Job Title:*

What experience do you have working with individuals from different backgrounds, religions, and ethnicities?*

What personal financial situations have you experienced that will help you relate to a participant? Note: This question allows administrators to match you with a participant that may be facing similar financial situations.*

What do you think causes most people to experience financial challenges?*

What would you like to learn more about regarding personal finances?*

The Coach Program is not an advice giving program; our focus is to empower participants through reflection, accountability, and encouragement. Are you comfortable with this approach?*

Effective coaching is based on a strong connection and relationship. We work to match coaches and participants who will work well together. To get better insight for matching purposes, we would like you to complete a quick, fun, personality profile that is available online:

https://animalinyou.com/

Please share the results of your personality profile.*

For matching purposes, we would like to know the ages of your children. (if none, enter n/a)*

How did you learn about this volunteer opportunity? (Please list the name of anyone who may have referred you.)*

The following questions are for ESL employees only.

Manager Name and Email address:

Manager Approval Date:

Branch/Department:

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